Individual
CRYSTAL JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2804 SPRING VISTA CT, PLANT CITY, FL 33566-9617
(813) 528-5922
Mailing address
2804 SPRING VISTA CT, PLANT CITY, FL 33566-9617
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
J525104977040
DRIVERS LICENSE
FL
Enumeration date
01/25/2023
Last updated
01/25/2023
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